This application for an NIMH Mid-Career Investigator Award in Patient- Oriented Research (K24) requests support for the candidate to integrate research in the pathogenesis and prevention of suicidal behaviors with the training of junior investigators in suicide studies. The candidate's long-term goal is to establish himself as a leader nationally in the study and prevention of suicide across the life course. Suicide is a major public health problem in the United States, yet there is a dearth of clinical researchers prepared to address the issue. The candidate's research objectives for the period of K24 support are to: (1) continue currently funded pre-intervention research to define risk factors for suicide among older people; (2) consolidate his skills and knowledge of epidemiologic and health services research methodologies, and develop collaborations with experts in preventive medicine for the study of suicide; and (3) establish a comprehensive array of suicide studies that includes preventive intervention and preventive systems services research at all ages. Three projects will serve as vehicles for achieving these objectives. Project 1 is an ongoing, NIMH R01-funded case-control study of completed suicide in the second half of life. Project 2 (R01 application currently pending review by AHCPR) is designed to investigate the effectiveness in a randomized, controlled trial of practice-based nursing case management and/or augmented Medicare benefits at reducing depression and suicidal ideation in functionally impaired patients in primary care. For Project 3 the candidate will establish local expertise in the use of manualized cognitive/behavioral therapies in controlled trials with functionally impaired patients in primary cre settings who re at risk for suicide. The mentorship objectives for the K24 award period are (1) for the candidate to shift his effort as Director of Psychiatry Residency Training (currently 50% of his time) to the mentorship of promising junior investigators in suicide studies; and (2) to attract trainees to suicide research careers from a variety of health care disciplines (psychiatry, psychology, epidemiology, preventive medicine, and others) and levels of training (students, residents, fellows, and junior faculty).